Whether it’s from a routine doctor visit or an extended hospital stay, the discharge process remains a complex and confusing process for patients and providers. On any given day, you can witness patients leaving a medical appointment with a stack of papers in hand, and often a look of confusion as they try to manage new instructions and an overload of information. But in this digitally connected, on-demand, telehealth-enabled healthcare ecosystem, could patient discharge be made easier through digital means?

Early discharge planning
For most health systems, the discharge process remains primarily paper-driven, with patients often leaving with a confusing set of paper instructions. Patients often complain about filling out multiple forms that ask for similar data or receiving conflicting discharge instructions. Unfortunately, during hospitalization, discharge planning is initiated late, and involvement with patients is often an afterthought that can lead to delays and poor at-home care.

Hospitals frequently stumble in their admission and discharge processes, particularly when it comes to efficiency and patient satisfaction. But major health systems are working to change this process. At John’s Hopkins, discharge and post-discharge care are planned in advance using predictive analytics based on the patient’s medical history, how well they are responding to initial treatment, and potential health related social factors (such as housing and family support). Once a patient leaves the hospital, connection is maintained through remote monitoring and digital engagement platforms to help guide patients through aftercare.

Using predictive data to plan discharge
Today, typically a nurse delivers tailored discharge instructions that are based on the patient’s condition, medical history, behavior, and attitude. Some patients require more time to understand and acknowledge the instructions than others. Nurses, often managing multiple patients, sometimes are not able to provide enough time for such patients. But as hospital processes go digital AI algorithms can be integrated into the discharge workflow to create customized discharge guidelines that can be delivered to the patient at discharge and throughout recovery.

Post-discharge, patients can use a personal device to track their condition and follow discharge instructions. This connectivity also allows patients to schedule follow-up appointments with various caregivers such as nutritionists, eye specialists, and pharmacists. Since the virtual care assistant is connected to the EHR system, all this interaction is automatically captured results of these visits. And through every interaction, AI is running throughout the system to learn from and improve processes for future interactions for both patients and providers.

Post-discharge connectivity
Once a patient leaves the hospital, communication gaps and fragmentation in the continuum of care arise all too easily. Family support during post-discharge can lead to better outcomes, but paper care packets and patient portal information provided at discharge are often confusing to patients and family members. According to a report by Reuters, patients often feel disconnected with limited communication options and confusing paper instructions written in technical or unfamiliar language.

Using a digital tool to guide patients and caregivers throughout the post-discharge aftercare can help to reduce gaps in information and support faster healing and outcomes. There are many consumer-grade and enterprise-level technologies available to support post-care communication initiatives. These range from EHR interoperability to patient communication devices, medication adherence devices and remote patient monitoring.

Imagine the art of the possible: using digital technology help patients throughout the care process—from admission to discharge. Drawing upon patient data and clinical assessments, providers can create a post-discharge care plan that reflects the patient’s specific needs, preferences, and resources. Digital health tools can then use personal measurements, environment, medication challenges, and health status to create a personalized support journey.

Through personalized care and guided support, digital technology can create discharge plans that increase patient comprehension and adherence. By adopting digital tools and integrating them from the start, patient discharge plans can be simplified and integrated into patients’ lives to help revolutionize the healthcare experience.